Bones II Flashcards
Most common bone tumors (2):
- Matrix producing
- Fibrous tumors
Most common benign bone tumors (2):
- Osteochondroma
- Fibrous cortical defect
Most common malignant bone tumor:
Osteosarcoma
Bone tumor hereditary associations (2):
- Li Fraumeni syndrome (p53)
- Hereditary retinoblastoma (Rb mutation)
Bone tumors of epiphysis (2):
- Clear cell chondrosarcoma
- Chondroblastoma
Bone tumors of diaphysis (2):
- Ewing sarcoma
- Fibrous dysplasia
Bone tumors of epiphysis/metaphysis (2):
- Giant cell tumor
- Aneurysmal bone cyst
Osteoma (3):
- Subperiosteal or endosteal cortex surface
- Woven and lamellar bone +/- marrow
- May obstruct sinus
Gardner syndrome:
Multiple osteomas
Osteoid osteoma (3):
- Less than 2cm size
- NSAID relief
- Pain most intense at night
Osteblastoma (3):
- Found in vertebrae posterior
- Size greater than 2 cm
- No NSAID relief
Osteosarcoma (4):
- Malignant osteoid
- Bimodal age
- Painful enlarging mass
- Codman triangle (tumor lifts periosteum)
Most common nonhematopoetic malignant primary bone tumor:
Osteosarcoma
Osteochondroma (3):
Exostosis
- Mushroom-shaped cartilage-capped enchodral ossification
- Metaphysis near growth plate of long tubular bones
- Marrow and cortex continuity
Chondroma:
Benign hyaline cartilage tumor
Enchondroma (3):
- Solitary in metaphysis of tubular bones
- Most common intraosseous cartilage tumor
- Nodules of hyaline cartilage with peripheral enchondral ossification
Increased risk for sarcoma transformation (2):
- Enchondromatosis (Ollier disease)
- Maffucci Syndrome: enchondromas with hemangiomas
Most common bone tumor of phalanx:
Enchondroma
Chondroblastoma is most common in:
Knee epiphyses
Two types of chondrosarcoma:
- Clear cell
- Conventional
Conventional chondrosarcoma x-ray:
Nodular growth with endosteal scalloping and flocculent densities from calcification
- Reactive thickened cortex bone
Clear cell chondrosarcoma (2):
- Teens/young adults
- Epiphysis
Fibrous cortical defect (2):
No bone formation
- Small
- Resolve into normal bone
Nonossifying fibroma (2):
- Large
- Persist
Three patterns of fibrous dysplasia:
- Monostotic
- Polystotic with soft tissue myxomas
- Polystotic with endocrine dysfunction (McCune-Albright sydrome)
Monstotic fibrous dysplasia (3):
- Majority
- Teens
- Incidental in most cases
Polystotic fibrous dysplasia (2):
- Mazabraud syndrome: soft tissue myxomas
- McCune-Albright syndrome
McCune-Albright syndrome (3):
- Cafe au lait skin pigmentations
- Sexual precocity
- Hyperactive G-protein of GNAS gene
Fibrous dysplasia (4):
- Well-circumscribed intramedullary
- Large may expand and distort bone
- Gross: tan-white and gritty
- Microscopic: Chinese character woven bone in fibrous stroma
Ewing sarcoma gene translocation:
t(11:22): EWS-FLI1
Ewing sarcoma/PNET x-ray:
Lytic destruction with onion skin periosteal reaction and sunburst pattern
Giant cell tumor of bone (3):
- Most commonly in the knee
- Benign locally aggressive tumor of macrophage/monocyte system
- Epiphyses but may extend into metaphysis
Aneurysmal bone cyst (ABC) (2):
- Multiloculated blood-filled cysts
- Metaphysis of long bones and vertebrae
Aneurysmal bone cyst x-ray:
Eccentric, expansile and well-demarcated
Most common form of skeletal malignancy:
Metastatic disease
Majority of skeletal metastasis comes from (5):
- Breast
- Lung
- Thyroid
- Kidney
- Prostate
